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Sunday, March 12, 2017

Tobacco control can save billions of dollars and millions of lives

WHO: Policies to control tobacco use, including tobacco tax and
price increases, can generate significant government revenues for health
and development work, according to a new landmark global report from
WHO and the National Cancer Institute of the United States of America.
Such measures can also greatly reduce tobacco use and protect people’s
health from the world’s leading killers, such as cancers and heart
disease. But left unchecked, the tobacco industry and the deadly impact
of its products cost the world’s economies more than US$ 1 trillion
annually in healthcare expenditures and lost productivity, according to
findings published in The economics of tobacco and tobacco control. Currently, around 6 million people die annually as a result of tobacco use, with most living in developing countries.The almost 700-page monograph examines existing evidence on two broad areas:

The economics of tobacco control, including tobacco use and
growing, manufacturing and trade, taxes and prices, control policies and
other interventions to reduce tobacco use and its consequences; and

The economic implications of global tobacco control efforts.

"The economic impact of tobacco on countries, and the general
public, is huge, as this new report shows," says Dr Oleg Chestnov, WHO’s
Assistant Director-General for Noncommunicable Diseases (NCDs) and
mental health. "The tobacco industry produces and markets products that
kill millions of people prematurely, rob households of finances that
could have been used for food and education, and impose immense
healthcare costs on families, communities and countries."Globally, there are 1.1 billion tobacco smokers aged 15 or
older, with around 80% living in low- and middle-income countries.
Approximately 226 million smokers live in poverty.The monograph, citing a 2016 study, states that annual excise
revenues from cigarettes globally could increase by 47%, or US$ 140
billion, if all countries raised excise taxes by about US$ 0.80 per
pack. Additionally, this tax increase would raise cigarette retail
prices on average by 42%, leading to a 9% decline in smoking rates and
up to 66 million fewer adult smokers."The research summarized in this monograph confirms that
evidence-based tobacco control interventions make sense from an economic
as well as a public health standpoint," says the monograph's co-editor,
Distinguished Professor Frank Chaloupka, of the Department of Economics
at the University of Illinois at Chicago.The monograph’s major conclusions include:

The global health and economic burden of tobacco use is enormous
and is increasingly borne by low- and middle-income countries (LMICs).
Around 80% of the world’s smokers live in LMICs.

Effective policy and programmatic interventions exist to reduce
demand for tobacco products and the death, disease, and economic costs
resulting from their use, but these interventions are underused. The WHO
Framework Convention on Tobacco Control (WHO FCTC) provides an
evidence-based framework for government action to reduce tobacco use.

Control of illicit trade in tobacco products is the key
supply-side policy to reduce tobacco use and its health and economic
consequences. In many countries, high levels of corruption, lack of
commitment to addressing illicit trade, and ineffective customs and tax
administration, have an equal or greater role in driving tax evasion
than do product tax and pricing. The WHO FCTC Protocol to Eliminate
Illicit Trade in Tobacco Products applies tools, like an international
tracking and tracing system, to secure the tobacco supply chain.
Experience from many countries shows illicit trade can be successfully
addressed, even when tobacco taxes and prices are raised, resulting in
increased tax revenues and reduced tobacco use.

Tobacco control does not harm economies: The number of jobs
dependent on tobacco has been falling in most countries, largely due to
technological innovation and privatization of once state-owned
manufacturing. Tobacco control measures will, therefore, have a modest
impact on related employment, and not cause net job losses in the vast
majority of countries. Programmes substituting tobacco for other crops
offer growers alternative farming options.

Tobacco control reduces the disproportionate health and economic
burden that tobacco use imposes on the poor. Tobacco use is increasingly
concentrated among the poor and other vulnerable groups.

Progress is being made in controlling the global tobacco
epidemic, but concerted efforts are needed to ensure progress is
maintained or accelerated. In most regions, tobacco use prevalence is
stagnant or falling. But increasing tobacco use in some regions, and the
potential for increase in others, threatens to undermine global
progress in tobacco control.

The market power of tobacco companies has increased in recent
years, creating new challenges for tobacco control efforts. As of 2014, 5
tobacco companies accounted for 85% of the global cigarette market.
Policies aimed at limiting the market power of tobacco companies are
largely untested but hold promise for reducing tobacco use.

Dr Douglas Bettcher, WHO Director for the Prevention of NCDs,
says the new report gives governments a powerful tool to combat tobacco
industry claims that controls on tobacco products adversely impact
economies. "This report shows how lives can be saved and economies can
prosper when governments implement cost-effective, proven measures, like
significantly increasing taxes and prices on tobacco products, and
banning tobacco marketing and smoking in public," he adds.Tobacco control is a key component of WHO’s global response to
the epidemic of NCDs, primarily cardiovascular disease, cancers,
chronic obstructed pulmonary disease and diabetes. NCDs account for the
deaths of around 16 million people prematurely (before their 70th
birthdays) every year. Reducing tobacco use plays a major role in
global efforts to achieve the Sustainable Development Goal of reducing
premature deaths from NCDs by one-third by 2030.